Efficacy of Xiaoxuming decoction combined with conventional western medicine in treatment of patients with acute ischemic stroke of wind-fire disturbance type
Objective To analyze the efficacy and mechanism of Xiaoxuming decoction combined with conventional western medicine in the treatment of patients with acute ischemic stroke of wind-fire disturbance type.Methods One hundred and eighty-eight patients with acute ischemic stroke of wind-fire disturbance syndrome type treated at Shangluo Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected for the randomized controlled trial.They were divided into a control group and a study group by the random number table method,with 94 cases in each group.There were 48 males and 46 females in the control group;they were(67.50±6.23)years old;their disease course was(7.21±1.15)h;58 cases had lesions in basal ganglia,27 cases brains,and 9 cases cerebellums.There were 49 males and 45 females in the study group;they were(67.00±8.46)years old;their disease course was(7.14±1.04)h;59 cases had lesions in basal ganglia,25 cases brains,and 10 cases cerebellums.The control group were treated with conventional western medicine,and the study group with Xiaoxuming decoction and conventional western medicine,for 28 d.The traditional Chinese medicine(TCM)symptom scores,scores of National Institute of Health Stroke Scale(NIHSS),and Barthel index scores before the treatment and after 28 days'treatment and the clinical efficacies were compared between the two groups.The levels of serum glial fibrillary acidic protein(GFAP),stromal cell-derived factor(SDF-1),brain-derived neurotrophic factor(BDNF),monocyte chemoattractant protein-1(MCP-1),homocysteine(Hcy),C-reactive protein(CRP),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),blood viscosity,fibrinogen(FIB),and D-dimer(D-D)before and after the treatment were compared.The safety during the treatment was compared.t test,x2 test,and rank sum test were used.Results After 28 days'treatment,the TCM symptom scores[(13.00±2.64)and(9.50±1.71)],NIHSS scores[(9.50±1.76)and(6.00±1.21)]and levels of GFAP[(5.02±1.25)μg/L and(4.21±0.98)μg/L],MCP-1[(112.28±10.29)μg/L and(92.58±7.41)μg/L],Hcy[(15.25±2.67)μmol/L and(8.56±2.21)μmol/L],CRP[(10.50±2.12)mg/L and(6.89±1.24)mg/L],MDA[(7.58±1.05)mol/L and(5.42±1.12)mol/L],whole blood high shear viscosity[(4.85±1.23)mPa/s and(2.58±1.05)mPa/s],whole blood low shear viscosity[(16.45±3.56)mPa/s and(10.89±1.98)mPa/s],plasma viscosity[(1.56±0.19)mPa/s and(1.35±0.15)mPa/s],FIB[(3.25±0.47)g/L and(2.68±0.35)g/L],and D-D[(1.91±0.29)mg/L and(1.39±0.26)mg/L]in the control group and the study group were lower than those before the treatment(all P＜0.001),and those in the study group were lower than those in the control group(all P＜0.001).After the treatment,the Barthel index scores[(65.00±9.35)and(74.50±8.76)]and serum levels of SDF-1[(502.94±29.32)μg/L and(550.75±30.56)μg/L],BDNF[(4.52±0.61)μg/L and(5.68±0.55)μg/L],SOD[(5.13±0.65)U/ml and(6.56±0.38)U/ml],and GSH PX[(34.32±6.87)mmol/L and(45.21±7.59)mmol/L]in the control group and the study group were higher than those before the treatment(all P＜0.001),and those in the study group were higher those in the control group(all P＜0.001).The total effective rate of the study group was higher than that of the control group[93.62％(88/94)vs.75.53％(71/94);x2=11.783,P＜0.001].There was no statistical difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Xiaoxuming decoction combined with conventional western medicine in the treatment of patients with acute ischemic stroke patients of wind-fire disturbance type can significantly improve their conditions and living abilities,and has significant curative effect and good safety.
万方数据
维普
